Hip-spine syndrome: the problem from the biomechanical point of view

Relevance Compensatory mechanisms of the lumbar spine-pelvis complex in concurrent degenerative changes remain a poorly understood problem. Numerous publications report data either from the point of view of spinal pathology or from the point of hip joint damage. Objective To evaluate changes in the parameters of the spine-pelvis sagittal balance in patients with the hip-spine syndrome. Materials and methods Two groups of patients with hip-spine syndrome were analysed: 1) "Hip-spine" group (n = 54) and 2) "Spine-hip" group (n = 66). All patients underwent radiographic examination. Radiographs of the spine with the capture of the head and hip joints in the anteroposterior and lateral projections in the standing position were taken. Results In the first group, the position of the pelvis was within normal anteversion or pelvic hyperanteversion. In the second group, pelvic retroversion was revealed; normal position of the pelvis (without its compensatory deviation) was present only in several cases. Discussion Regularities in the compensatory mechanisms in the hip-spine syndrome variants have been identified. However, cases with pelvic retroversion require further study and assessment of the balance after surgery. Conclusion Compensatory mechanisms in hip-spine syndrome depend on the dominance of the pathological process (joints or spine), which must be considered in evaluation of the parameters of the sagittal balance in these patients.